challenges in the diagnosis and treatment of pemphigus vulgaris: clinical case reports

ORAL AND MAXILLOFACIAL PATHOLOGY OOOO

e146 Abstracts February 2014

analysis of the PTPN11 gene showed a mutation and the patientwas diagnosed with NS. Treatment was performed with drugs andsome GCL reappeared, so surgery was done. The patient has beenfollowed up for 4 years. Few cases of NS show MGCL, but theycan be instructive when obtaining a diagnosis.

PE-070 - RADIOPROTECTIVE INTRAORAL APPLIANCEAS SOLE RADIOTHERAPY FOR CARCINOMA OF LIP:CASE REPORT. MARIO RODRIGUES DE MELO FILHO,BRENO AMARAL ROCHA, MARIA BETÂNIA DE OLIVEIRAPIRES, LUCIANNE MAIA COSTA LIMA, ANGEL DA SILVAMARTINEZ, EDIMILSON MARTINS DE FREITAS,HERCÍLIO MARTELLI JÚNIOR. UNIVERSIDADE ESTAD-UAL DE MONTES CLAROSeUNIMONTES.

Radioprotective oral appliances can be used during radio-therapy (RT) to prevent radiation-induced oral complications.Three women and 2 men with squamous cell carcinoma (SCC) ofthe lip (T1-T2N0M0), age 46 to 72 years, were eligible forcurative RT with electron beam (60 to 66 Gy) and the use ofpersonalized radioprotective oral appliances. Patients were eval-uated before, during, and after RT for xerostomia and mucositiswith scales (Eisbruch et al and World Health Organization). Onepatient complained of mild oral dryness that did not interfere withfunction; the others showed no xerostomia. Except for the tumormargins, protected areas of the oral mucosa showed no radiationmucositis, nor did patients experience taste alterations. The oralappliances prevented unnecessary irradiation of normal tissues,thus reducing the risk of morbidity in the form of mucositis andosteoradionecrosis. Treated patients had no signs of recurrence.Acknowledgment: FAPEMIG.

PE-071 - CASTLEMAN’S DISEASE: CASE REPORT. ADRI-ANA BORGES OLIVEIRA, LAIRA RENATA LEMOSSANTOS, JÉSSICA OLIVEIRA MELO SILVA, VIVIANEALMEIDA SARMENTO, PATRÍCIA LEITE RIBEIROLAMBERTI, ANTONIO FERNANDO PEREIRA FALCÃO,DAVI SILVA CARVALHO CURI. FEDERAL UNIVERSITYOF BAHIA.

Castleman’s disease (CD) is a rare, atypical, lymphoproli-ferative disease that occurs in three histopathological variants:hyaline vascular, plasma cell, and mixed. Woman, 61, hadpainless, mobile lymphadenopathy in the left anterior cervicalregion that was associated with abdominal distension andenlargement of the submandibular glands. After biopsy and his-topathological evaluation, a diagnosis of CD/hyaline vascularvariant was made. Therapy with corticosteroids plus two sessionsof chemotherapy (cyclophosphamide, hydroxydaunomycin,Oncovin, and prednisone [CHOP] and CHOP plus rituximab[R-CHOP]) was undertaken. The patient developed mucositis.The differential diagnosis and management of this condition arediscussed.

PE-072 - ODONTOGENIC KERATOCYSTOF THE JAW:CASE REPORT. SAMARA RAMOS DE SOUZA, PIETRY DYTARSO INÃ ALVES MALAQUIAS, BRÁULIO CARNEIROJÚNIOR, VIVIANE ALMEIDA SARMENTO, ROBERTOALMEIDA DE AZEVEDO, RAFAEL FERNANDES DEALMEIDA NERI, SAMARA ARMOS DE SOUZA. FACUL-DADE DE ODONTOLOGIA UFBA.

Keratocystic odontogenic tumor (KOT) is a lesion that af-fects the gnathic bones, mainly in the posterior jaw area. Clinicaland radiographic characteristics include asymptomatic volumetric

increase and lack of cortical bone expansion and are related to animpacted tooth. However, the diagnosis can be confused forothers when the lesion presents in other areas, such as the peri-apical region. In these cases, different management is recom-mended. This paper reports a case of KOT that demonstratedclinical and radiographic findings resembling those of radicularcyst and is designed to educate professionals who may see thislesion, such as endodontists and pathologists, about the possi-bility of a periapical presentation.

PE-073 - CHALLENGES IN THE DIAGNOSIS ANDTREATMENT OF PEMPHIGUS VULGARIS: CLINICALCASE REPORTS. THAMIRES SILVA SOUZA, ANDRÉLUCAS D’ALMEIDA LYRIO DOS SANTOS, DAVI SILVACARVALHO CURI, VINICIUS VIEIRA, ANTÔNIOFERNANDO PEREIRA FALCÃO, PATRICIA LEITERIBEIRO LAMBERTI, VIVIANE ALMEIDA SARMENTO.FEDERAL UNIVERSITY OF BAHIA.

Bullous autoimmune diseases are lesions in which autoanti-bodies are produced against the structural components thatmaintain cell-cell and cell-matrix adhesion in the skin and mu-cous membranes. They include disorders in which the bubbles arefound in the basal membrane zone and those where bubbles formwithin the epidermis (pemphigus vulgaris, pemphigus foliaceus,and other subtypes). Due to the considerable overlap in clinicalpresentation of these conditions, diagnosing autoimmune bullousconditions of the skin and oral mucosa can be a challenge. In thelast decade, there have been advances in the diagnosis of auto-immune bullous conditions. Two cases of bullous lesions diag-nosed as pemphigus vulgaris were discussed, along with properclinical management and differential diagnostic issues.

PE-074 - CHONDROBLASTIC OSTEOSARCOMA:CASE REPORT. FERNANDA TENÓRIO LOPES BARBOSA,BRUNNO SANTOS DE FREITAS SILVA, ALINECARVALHO BATISTA, ELISMAURO FRANCISCO DEMENDONÇA, MARÍLIA OLIVEIRA MORAIS, FERNANDAPAULA YAMAMOTO. UNIVERSIDADE FEDERAL DEGOIÁS.

Osteosarcoma is a rare malignant neoplasm in the jawsoriginating from mesenchymal cells that can form bone andosteoid tissue. The three histological patterns are osteoblastic,fibroblastic, and chondroblastic. Young man, 18, was referred toour service with an asymptomatic firm nodule present for 1 monthin the posterior region of the mandible. Imaging revealed anosteolytic lesion associated with widening of the periodontalligament space and root reabsorption, extra-lingual corticalreabsorption, and absence of calcification or “sun ray appear-ance.” Histopathological specimens revealed numerous spindleand oval-shaped pleomorphic cells with few osteoid and chon-droid formations, compatible with a diagnosis of chondroblasticosteosarcoma. Surgical resection, adjuvant chemotherapy, andtibia graft were the chosen treatment. No recurrence or metastasisdeveloped in 1 year of follow-up. This case emphasizes theimportance of identifying the histological type of osteosarcoma todefine the prognosis of chondroblastic osteosarcoma in youngpatients.

PE-075 - CHONDROBLASTIC OSTEOSARCOMA:DIAGNOSTIC DIFFICULTIES IN INCISIONAL BIOPSY.LARA CRISTINA OLIVER GIMENEZ, BRUNO TAVARESSEDASSARI, LILIAN CALDAS QUIRINO, CIBELE